A nurse in the emergency department is assessing an older adult client who has community-acquired pneumonia. Which of the following findings should the nurse expect?

Hypertension

Unequal pupils

Confusion

Tympany upon chest percussion

Answer and Explanation

The Correct Answer is C

A. Hypertension is not typically associated with pneumonia, especially in older adults. Pneumonia can lead to hypotension or sepsis, but not usually hypertension.
B. Unequal pupils are not a typical finding associated with pneumonia. This could suggest a neurological issue or a possible eye problem, not a respiratory infection.
C. Confusion is a common sign of pneumonia in older adults, especially in the elderly, who may present with altered mental status due to hypoxia, infection, or dehydration. Delirium or confusion is a common manifestation of pneumonia in this population.
D. Tympany on chest percussion suggests air in the abdominal cavity, not in the lungs, and is not typically associated with pneumonia. Pneumonia is more likely to present with dullness upon percussion due to consolidation in the lungs.

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Correct Answer is C

Explanation

A. The head of the bed should be elevated to at least 30-45 degrees to help prevent aspiration and reduce the risk of ventilator-associated pneumonia (VAP). Flat positioning increases the risk of aspiration and subsequent pneumonia.
B. Humidification is important for preventing drying of the respiratory passages but does not directly reduce the risk of VAP.
C. Turning the client every 2 hours (not just 4) is a key practice to prevent VAP by improving lung expansion, promoting drainage, and reducing the risk of ventilator-associated pneumonia.
D. Oral care, including brushing the teeth, should be done more frequently than every 12 hours. The current guidelines recommend brushing the client's teeth every 4-6 hours and using suctioning as needed to prevent oral bacterial buildup that can lead to VAP.

A. Visual deterioration B. Diabetes C. Meningitis D. Hypoglycemia

Correct Answer is C

Explanation

A. Visual deterioration is not typically associated with nasal drainage following a hypophysectomy unless the optic nerves or structures are affected during surgery.
B. Diabetes is not related to the glucose content in the nasal drainage; it's unrelated to this situation.
C. The presence of glucose in the drainage indicates a possible cerebrospinal fluid (CSF) leak, as CSF contains glucose. A CSF leak increases the risk of meningitis due to the direct connection to the central nervous system.
D. Hypoglycemia is not associated with the glucose content of drainage fluid. This is more relevant to blood glucose levels.

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A nurse in the emergency department is assessing an older adult client who has community-acquired pneumonia. Which of the following findings should the nurse expect?

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